Neurologic Complications After Repeat Epidural Blood Patch in Recurrent Spontaneous Intracranial Hypotension: A Case Report
Soo ah Cho
Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Gurodong-ro 148, Guro-gu, Seoul-08308, Republic of Korea.
Jihyun Song *
Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Gurodong-ro 148, Guro-gu, Seoul-08308, Republic of Korea.
Seok woo Jeong
Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Gurodong-ro 148, Guro-gu, Seoul-08308, Republic of Korea.
Young Ju Won
Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Gurodong-ro 148, Guro-gu, Seoul-08308, Republic of Korea.
*Author to whom correspondence should be addressed.
Abstract
A 61-year-old male patient presented to Guro Korea University Medical Center with a one-month history of increasingly severe headaches that were aggravated by an upright position and alleviated by a supine position. The patient had no other specific underlying disease. Epidural blood patch was repeatedly performed several times because headache was not fully subsided, 10 minutes after fourth EBP, the patient showed a decrease in motor grade 1 in both lower limbs, Lt. Upper limbs and Grade 3 for Rt. upper limbs. Urgent surgical evacuation of spinal epidural hematoma was conducted. After operation, patient recovered from neurologic deficit.
While epidural blood patches are generally considered safe and effective for treating SIH, like any medical procedure, there can be potential complications. It's important to note that complications are relatively rare, and the benefits of the procedure often outweigh the risks. When we repeatedly perform epidural blood patches, more caution is required. Careful evaluation of absolute indications is necessary to prevent additional complications and possible complications should be seriously considered.
Keywords: Epidural blood patch, quadriplegia, neurologic deficit, spontaneous intracranial hypotension, CSF leakage